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General NPI Number Information
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NPI Number | 1215231543
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Entity Type | Organization
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Legal Business Name | UNIVERSAL CONCEPTS
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 241 OAK RIDGE DR
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City | RADCLIFF
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State | KY
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Zip | 40160-1521
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Country | US
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Telephone | 270-351-4859
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Fax |
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Provider Business Mailing Address
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Address Line | 241 OAK RIDGE DR
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City | RADCLIFF
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State | KY
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Zip | 40160-1521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DEVELOPMENTAL INTERVENTIONIST
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Name | MS. NONA CROOM
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Credential |
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Telephone | 859-552-6112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | KY
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